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Apolipoprotein B/apolipoprotein A1 ratio and non-high-density lipoprotein cholesterol. Predictive value for CHD
P Liting1, L Guoping, C Zhenyue
1Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No.197, Ruijin 2nd Road, Shanghai, China.
Insights
The combination of apolipoprotein B/apolipoprotein A1 ratio and non-high-density lipoprotein cholesterol effectively predicts coronary heart disease severity and patient outcomes. This combined lipid profile offers superior prognostic information compared to individual markers.
Area of Science:
- Cardiovascular Medicine
- Lipid Metabolism
- Clinical Diagnostics
Background:
- Coronary heart disease (CHD) poses a significant global health burden.
- Accurate assessment of CHD severity and prognosis is crucial for patient management.
- Routine lipid profiles have limitations in fully capturing cardiovascular risk.
Purpose of the Study:
- To evaluate the clinical utility of combined apolipoprotein B/apolipoprotein A1 (apoB/A1) ratio and non-high-density lipoprotein cholesterol (non-HDL-C) in assessing CHD severity.
- To determine the predictive value of these markers for in-hospital CHD events.
- To assess their role in predicting the long-term prognosis of patients with CHD.
Main Methods:
- Coronary angiography was used to classify 826 patients into CHD (n=532) and normal (n=294) groups.
- Serum apoB/A1 ratio and non-HDL-C levels were measured at baseline.
- Gensini score and logistic regression analyzed associations with CHD severity; in-hospital events and 3-year follow-up data were collected.
Main Results:
- Both apoB/A1 ratio and non-HDL-C increased with the number of stenotic coronary branches.
- The apoB/A1 ratio remained significantly associated with multi-branch lesions and Gensini score after adjustment.
- Combined high levels of apoB/A1 and non-HDL-C were linked to the highest risk of multi-branch lesions, in-hospital events (heart failure, cardiac death), and adverse outcomes at 3-year follow-up.
Conclusions:
- The combination of apoB/A1 ratio and non-HDL-C is a valuable predictor of CHD severity.
- This combined lipid marker provides enhanced prognostic information compared to individual lipid components or routine profiles.
- Utilizing this combination can improve risk stratification and long-term management strategies for CHD patients.
Background And Aims:
To explore the clinical value of the combination of apolipoprotein B/apolipoprotein A1 (apoB/A1) and non-high-density lipoprotein cholesterol (HDL-C) in evaluating the severity of coronary heart disease (CHD) and in predicting in-hospital CHD events and the long-term prognosis of CHD patients.
Methods:
According to the results of coronary angiography, 826 patients were enrolled and classified into a CHD group (532 cases, including single-branch stenosis group, n = 165; double-branch stenosis group, n = 175;and multi-branch stenosis group, n = 192) and a normal group (294 cases). The serum apoB/apoA1 ratio and non-HDL-C were calculated at baseline. The Gensini score and logistic regression were applied to analyze the association between the apoB/apoA1 ratio, non-HDL-C, and the severity of CHD. Major in-hospital adverse incidents were recorded and follow-up telephone interviews were conducted 3 years after discharge.
Results:
Both the apoB/apoA1 ratio and non-HDL-C rose with the number of stenotic coronary branches. Only apoB and apoB/apoA1 remained significantly associated with the risk of multi-branches lesions and the Gensini score after adjustment. Patients with combined high levels of apoB/apoA1 and non-HDL-C (N = 50, 43.10 %) suffered from the highest risk of multi-branches lesions. Similarly, patients with combined high levels of apoB/apoA1 and non-HDL-C not only suffered from the highest risk of in-hospital new-onset heart failure and cardiac death (16.38 % vs. 10.35 %), but also had the highest risk of adverse events, angina, myocardial infarction, new-onset heart failure, stroke, and cardiac death after an average 3-year follow-up.
Conclusion:
The combination of apoB/apoA1 and non-HDL-C is predictive of the severity of CHD, and it could provide more prognostic information than its individual components or other routine lipid profiles.
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